Robert R.
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Robert R. (early 1954 – May 16, 1969) was an African-American Missouri teenager who was the victim of the first confirmed case of HIV/AIDS in North America. His death baffled doctors, due to the fact that AIDS was not discovered and officially recognized until June 5, 1981, when five San Francisco doctors discovered the disease, long after Robert's death. After AIDS research was gained interest in the scientific community in 1984, one of the doctors who had examined Robert sent in his tissues for an HIV test, both of which were positive.
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[edit] Illness
In late 1968, Robert R. (whose last name has been kept confidential) admitted himself to the Barnes-Jewish Hospital (then called the Barnes Hospital) and was revealed to have extremely large amounts of chlamydia cells in his blood stream and his legs and genitals were covered in warts and sores. He had grown thin and pale and suffered from shortness of breath. He told the doctors that he had had the condition since at least late 1966. Robert explicitly turned down a rectal examination from the staff. He had admitted that he was sexually active, but did not specify whether he was heterosexual or homosexual (it is today thought that he was homosexual). In early 1969, his condition seemed to have stabilized, but by March his condition came back, even worse than before. His breathing became harder and his white blood cell count plummeted. The doctors found that his immune system had somehow ceased to function. He then developed a fever and died on May 16.
[edit] Autopsy
On the day of his death, the doctors immediately performed an autopsy on him and found extremely odd abnormalities in his body. The autopsy, led by Dr. William Drake, revealed a small purplish lesion on his left thigh, and more of them in his soft tissue. Drake concluded that the lesions were in fact tumors called Kaposi's sarcoma, a rare type of cancer that mostly affected elderly Jewish and Italian men. However, Kaposi's sarcoma, if found in those under the age of sixty, is today a symptom of AIDS. The cancers were also found in his rectum and anus, which it had never occurred in during previous cases. This baffled the doctors, and the case was eventually published in a medical journal in 1973. After the autopsy, some of his remains were kept in cold storage at facilities at the University of Arizona and at the laboratory of Dr. Memory Elvin-Lewis, who had assisted in Robert's autopsy.
[edit] Tests
In 1984, three years after AIDS was officially discovered and had started spreading at dangerous levels in New York City and Los Angeles, Dr. Marlys Witte, one of the doctors who, like Elvin-Lewis, had looked after Robert and also assisted in the autopsy, thawed and tested preserved samples of Robert's remains. In the remains were found antibodies to Herpes simplex, cytomegalovirus, and Epstein-Barr virus, three diseases common among homosexual men, especially those with AIDS. Five years later, in June 1989, Witte decided to test Robert's remains against using more recent technology, settling on Western Blot, one of the most powerful antibody-detection tools available. The Western Blot found that all nine HIV proteins were present in Robert's blood. A second test was done, showing the same results.
[edit] Impact on AIDS origin research
Since Robert had never traveled outside of the United States and had told doctors that he had never received a blood transfusion, the Robert R. case raises more questions than answers. Since Robert's infection was almost certainly through sexual contact and he had never left the country, it is obvious that he must have received the virus from somebody else already living with the virus in the United States, meaning that AIDS was present in North America before he received the virus in 1966.
